Last month, Asia Catalyst attended the 26th International Harm Reduction Conference in Porto, Portugal. Harm reduction, or mitigating the negative consequences of drug use and making sure responses are rooted in human rights and social justice, is at the heart of what we support.

Portugal was an apt destination for the meeting, as it has been a leader in drug policy reform. For the last 18 years, Portugal has not treated personal drug use as a criminal offense. Their approach favors a “Dissuasion Commission” made of social workers, psychologists, and legal experts who work together to assess patients and connect them with the right services. As a result, more people are voluntarily entering treatment and the “overdose deaths, HIV infections, problematic drug use, and incarceration for drug-related offenses have plummeted,” Drug Policy Alliance reports.

Conversely, in Asia where we work, most governments rely on punitive, repressive tactics that undermine public health in spite of massive HIV, HCV, and shamefully under-documented overdose epidemics. The majority of people in prison are there for nonviolent drug-related offenses, and 11 countries still use forced detention in spite of a pan-UN agency opposition to the approach.

In Porto, our staff – Khine Su Win, Myanmar Program Officer, Guo Miao, Senior Program Officer, and Shen Tingting, Director of Research, Advocacy, and Policy – joined sessions, learning about strategies and solutions conceived by organizations and allies around the world. In Kenya, for example, the Muslin Education and Welfare Association has an outreach team working with the courts and police to identify people who use drugs before court dates and refer them to treatment programs rather than incarceration. In South Africa, a new community program is screening people for substance use, and running the country’s first publicly funded harm reduction, opioid substitution therapy, and needle exchange program. And AIDS Care China is piloting take-home methadone for drug users and working with police to allay concerns that the drug will end up on the black market.

Not every country, of course, is taking such an expansive people-first approach.

On the last day of the conference there was a protest to draw attention to the thousands of people killed in the war on drugs in the Philippines, where 33 people are murdered each day and thousands more held in over-crowded prisons. Other Asian countries like Indonesia have followed suit with their own drug wars. But according to a recent International Drug Policy Consortium report, use of illegal drugs has gone up by nearly a third in the last decade – proof that the punitive approach is not working.

Khine presented on Asia Catalyst’s work in Myanmar with a youth-based organization, Youth Empowerment Team (YET), to document how closing harm reduction drop-in centers is affecting people who use drugs in Yangon. Khine has trained YET and other grassroots groups to interview people who inject drugs about the problems they now face as a result of dramatically limited access to health services, including clean injecting equipment and HIV and hepatitis testing and counseling. YET’s research showed that the drop-in centers were “a lifeline” for hundreds of people now grappling with growing isolation, and without a safe space to foster healthy ways of coping.

The takeaway: in Myanmar and across the globe, there is an urgent need to invest in and expand community-run spaces where people who use drugs can feel safe and receive essential harm reduction services, including naloxone treatment for overdose prevention and support. And support directly-affected groups with the tools and resources to advocate for an enabling legal environment where they can thrive.

With great thanks,

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